A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
If a motor accident worsens a pre-existing injury, claimants in Bathurst must navigate NSW CTP rules to resolve disputes. Under the Motor Accident Injuries Act 2017, SIRA evaluates whether the aggravation meets threshold injury criteria. This article explains how to challenge SIRA decisions, document evidence, and pursue dispute resolution under NSW law.
How SIRA Assesses Pre-Existing Injury Aggravation
SIRA determines if an aggravation qualifies as a 'threshold injury' under the Motor Accident Guidelines. This requires medical evidence showing the accident caused a new or worsened condition. For example, if a claimant with a pre-existing back injury experiences increased pain and reduced mobility after a crash, SIRA will assess whether this constitutes a new injury.
Key factors include:
- Medical records proving the aggravation
- Evidence linking the accident to the worsened condition
- Compliance with the spinal nerve-root qualification (per Motor Accident Guidelines)
Disputes often arise when SIRA disputes the link between the accident and the aggravation. Claimants must provide detailed medical reports and expert opinions to support their case.
Dispute Resolution Options in NSW
Claimants have two main pathways to challenge SIRA decisions:
1. Internal Review by SIRA
If a claimant disagrees with SIRA's assessment, they can request an internal review. This involves submitting additional evidence or clarification. SIRA will reassess the claim based on the new information.
2. External Review by the Personal Injury Commission
If the internal review outcome is unsatisfactory, claimants can seek an external review by the Personal Injury Commission (PIC). The PIC will consider whether SIRA's decision was legally sound. Note that this process does not guarantee a changed decision.
Disputes over pre-existing injuries often require specialist medical evidence. Claimants should seek independent medical opinions to challenge SIRA's interpretation of their condition.
Practical Steps for Claimants in Bathurst
To strengthen a claim, claimants should:
- Obtain medical records showing the pre-existing injury and its aggravation
- Document the accident date, location, and circumstances
- Gather witness statements and photographic evidence
- Submit all information to SIRA within the 52-week statutory period for benefits
If the injury is classified as a 'threshold injury' under the Motor Accident Guidelines, weekly benefits may be limited after 52 weeks. Claimants must demonstrate that the aggravation meets the threshold criteria to avoid benefit cuts.
Time Limits and When to Seek Advice
Claimants must submit their claim to SIRA within 52 weeks of the accident. If the injury is not a threshold injury, benefits may stop after this period. For disputes over aggravation, claimants should seek legal advice before the 52-week deadline to ensure all evidence is properly submitted.
Disputes over pre-existing injuries can be complex. Claimants in Bathurst should consult a solicitor experienced in NSW CTP claims to navigate SIRA's evaluation process and challenge decisions where necessary.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.